What Are The Most Unpredictable Specialty Training Programmes?

Messly helps doctors make evidence-based decisions about their careers.

As doctors, we would never make clinical decisions without the evidence to back up our actions. So why should we not take the same approach to our training? Messly’s belief is that knowledge is power; the more junior doctors know about what they are applying to the happier they will be in their jobs. Happier junior doctors will lead to the one thing all doctors agree we want: better care for patients.

In this blog we consider which speciality training programmes offer the most predictable and unpredictable quality of the training. This is a very important question to consider when applying for specialty training, as the quality of training may vary hugely between hospitals and regions, and often we do not have control over these factors to so we need to know how much of a gamble we are taking.

To do this analysis, we have explored which specialities offer the best and worst clinical supervision at Core level, and compared this to the amount of variation that exists between the ratings for different hospital rotations within that specialty.

Clinical supervision is the day-to-day support doctors in training receive in their departments. Of course, this is critical to the training experience, and to the overall experience that junior doctors get from a rotation. The variability assesses how much variation (using standard deviation) there is between ratings in that specialty. This is important because high variability means there is more of a risk when applying to that specialty, as there will be poor rotations mixed in with the great ones.

So, you should be looking for specialties with high clinical supervision ratings and low variability.

All of the data is based on the ratings given by doctors from across the country for all specialties at Core and Specialty grade in GMC 2016 Survey. Of course, this decision is nuanced and involves a number of personal factors, but we hope that this snapshot will provide an interesting and thought-provoking overview to kick start your research and analysis.

Here are the results of our number crunching:

Notes: We have only included specialties which offered rotations at over 70 hospitals across the UK in 2016. Other specialties have been excluded. Data is sourced from the GMC National Training Survey 2016. Variability is calculated as the standard deviation of ratings within that specialty. Please head to http://www.gmc-uk.org/education/surveys.asp to access the source data in full and read a full explanation of the methodology used by the GMC.

Key takeaways:

1) Do your research before applying to Acute Internal Medicine, Emergency Medicine and General Medicine – these are the most unpredictable training programmes

Our analysis shows that specialties like these with below average clinical supervision are generally the ones with the the most variability between rotations, whilst the best specialties for clinical supervision are generally the most consistent too.

For specialties such as Acute Internal Medicine, Emergency Medicine and General Medicine, you need to do careful research before applying as the variability is very high and overall scores much lower than average. There will be many hidden gems but also many poor quality rotations. Sign up to use our Training Navigator and read hospital reviews from doctors working in these rotations to identify these.

2) Anaesthetics and Radiology stand out for being the most consistent training programmes

These specialties have the highest scores for clinical supervision and lowest variation in ratings, which means they are reliably good training programmes across the country. So there are the ‘safe bets’ when applying at Core level and is consistent with our previous analysis which showed that these trainees are most satisfied in these specialties.

One example of a great anaesthetics rotation is Hammersmith Hospital. It has been well reviewed by a Messly Doctor as a ‘great post for novices’. There’s evidence of good clinical supervision with SHO’s been able to ‘lead the case with the support of the registrar’ in renal and pancreas transplants.

3) This is only part of the picture – our Training Navigator will tell you more.

The figures in this blog are for all regions, and there will be variation between different regions and different grades. Our Training Navigator can help you deep dive into the quality of training, clinical supervision and workload at specific rotations within these regions, and pick out the specific hospitals that are right for you.

These are the most comprehensive and up-to-date ratings for individual NHS hospital rotations, with five star ratings based on the results of the 2016 GMC National Training Survey.